CareSource Telemedicine Option (MyIdeal Doc)

At the start of the COVID-19 pandemic, the Ohio Department of Medicaid (ODM) acted quickly to implement an emergency telehealth rule, Ohio Administrative Code §5160-1-21. This rule temporarily expanded the scope of telehealth services for the Ohio Medicaid program to increase access to medical and behavioral health services using telehealth. That temporary expansion rule supersedes the existing telehealth regulation during any time period in which the Governor of the State of Ohio declares a state of emergency. After the state of emergency is over, telehealth use in the Medicaid program would have reverted back to the prior limited telehealth rule. On October 19, 2020, the Joint Committee on Agency Rule Review (JCARR) made the temporary expansion of telemedicine services in the Ohio Medicaid program, brought on by the pandemic, permanent.

ODM was seeking to make the rule changes permanent after the pandemic is over to ensure that patients have access to access to health care even with limits on in-person contact. The rule changes to Ohio Administrative Code §5160-1-18 include:

• Expanding the definition of telehealth to include telephone calls, remote patient monitoring and other electronic communication that does not have both audio and video elements;
• Expanding the types of practitioners who are eligible to provide telehealth services, including home health and hospice aides, behavioral health practitioners, Medicaid school program providers, optometrists, dentists, dietitians, and physical and occupational therapists;
• Fewer restrictions on patient and practitioner site locations;
• Expanding the types of telehealth services that may be paid for by Medicaid, including virtual check-in by a physician or other qualified health care professional who can report evaluation and management services, online digital evaluation and management services, remote patent monitoring, physical therapy, occupational therapy, audiology, speech-language therapy and additional behavioral health services.

The use of telehealth services has increased significantly during the pandemic, and the Ohio Department of Mental Health & Addiction Services has recognized that continued expansion of telehealth services would improve outcomes for patients long after the pandemic was over, particularly with regard to behavioral health services.

This is for informational purposes only. It is not intended to be legal advice and does not create or imply an attorney-client relationship.

TAMRA PRUITT
Community Education & Marketing Representative
230 North Main Street, Dayton, OH 45402
937.475.5319 | CareSource.com
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